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01-03-2015 | HIV Pathogenesis and Treatment (AL Landay, Section Editor)

Persistent High Mortality in Advanced HIV/TB Despite Appropriate Antiretroviral and Antitubercular Therapy: an Emerging Challenge

Authors: Gregory P. Bisson, Nicola Zetola, Ronald G. Collman

Published in: Current HIV/AIDS Reports | Issue 1/2015

Abstract

Approximately 1.1 million, or 13 %, of all TB cases in 2013 were coinfected with HIV, and in some African countries, such as Botswana and Swaziland, 60–80 % of TB cases are coinfected with HIV. Effective therapies for both HIV and TB exist, yet patients presenting with TB and advanced HIV still experience high rates of morbidity and mortality despite initiation of both antitubercular and antiretroviral therapy (ART). Previous reviews and research have focused largely on TB-associated immune reconstitution inflammatory syndrome (TB-IRIS) as a type of complicated outcome on ART in advanced HIV/TB, but recent data indicate that immunologic failure despite suppressive ART is associated with early mortality. In this review, we examine recent findings regarding early mortality in HIV/TB and emerging concepts in the pathophysiology of TB-IRIS, in order to provide an integrated view of factors determining outcomes in coinfected people as well as highlight key needs for future research and therapeutic development.

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Title: Persistent High Mortality in Advanced HIV/TB Despite Appropriate Antiretroviral and Antitubercular Therapy: an Emerging Challenge
Authors: Gregory P. Bisson
Nicola Zetola
Ronald G. Collman
Publication date: 01-03-2015
Publisher: Springer US
Published in: Current HIV/AIDS Reports / Issue 1/2015
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-015-0256-x

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